CASUAL NEW STARTER FORM

Part 1: Personal Details – To be completed by the Casual worker

Department / Staff No (If already a employee)
Title (Miss/Mrs/Ms/Mr/Dr) / National Insurance No
Forename(s) / Surname

Are you a Student? (Please Circle)YES NO

Date of Birth (DD/MM/YY) / Gender(Please Circle) / MALE / FEMALE / OTHER
Address
Post Code
Email Address / Nationality
Bank/Building Society Name
Branch Address
Sort Code / - / -
Account Number

The University of Liverpool is an equal opportunities employer. We need to carry out equalities monitoring in order to meet our statutory obligations and to make sure our Human Resources processes are working to promote equality for all. Please help us do this by ticking the appropriate boxes below.If you do not want to provide this information please tick the prefer not to say box.

Disability / Do you have a disability as defined by the Equality Act 2010?
YES / NO / Prefer not to say
(If YES please tick the relevant box)
Prefer not to say
Specific Learning Difficulty
General Learning Disability
Cognitive impairment / Long Standing Illness / Visual Impairment
Physical Impairment / Mental Health Condition
Hearing Impairment / Other

Ethnic Origin(Please tick one box)

White / Black/African/Caribbean/British / Other Ethnic Group
English, Welsh, Scottish, British / Black/ Black British- Caribbean / Arabic
Irish / Black /Black British - Black African / Other Ethnic background
Gypsy or Traveller / Other Black background
Any other White Background
Asian / Asian British / Mixed / Multiple ethnic group
Asian or Asian British - Indian / Mixed - White & Black Caribbean
Asian or Asian British - Pakistani / Mixed - White & Black African / Prefer not to say
Asian or Asian British - Bangladeshi / Mixed - White & Asian
Chinese / Other Mixed background
Other Asian background

Religion(Please tick one box)

Prefer not to say / Buddhist / Muslim
No Religion or Belief / Hindu / Sikh
Christian / Jewish / Any other Religion

Sexual Orientation(Please tick one box)
Prefer not to say / Gay Woman / Lesbian / Bisexual
Straight / Heterosexual / Gay Man / Other

In order to comply with the Immigration, Asylum and Nationality Act 2006, the University is required to obtain documentary proof of a workers legal right to work in this country. Please ensure you have provided the necessary right to work documentation to your department along with this form. Please also ensure you provide a P45 or P46. Guidance is available here

Worker Signature...... Date......

Part 2: About the position - For completion by the authoriser and department administrator

Start Date / - / - / End Date* / - / -

*If the end date exceeds 8 weeks from the start date you should contact your HR Manager

Job Title
Description of work to be undertaken
Account / Cost Centre
Dept 1 / 2 Code
*Hourly rate / Spinal Point(from UoL salary scales)
*All casuals should be engaged on an hourly rate that equates to the University of Liverpool pay spine which is available via this link the exception of those that are paid against nationally agreed rates of pay, for example Clinical Academics. In some exceptional circumstances it may be agreed to pay one-off payments, however before agreeing these you must seek clarification from your HR Manager that this is acceptable. Please note that the casual worker must complete a timesheet to claim for the work they have undertaken. No hours or one-off payments will be paid from this form.The timesheet must be signed by the worker, the line Manager (to confirm the work has been completed in line with agreed requirements) and 1 authorised signatory.

Reference Table 1 – Occupation Code (UK Government Standard Occupational Classification). Please tick category

Academic Non-Clinical Teaching, Examining, Demonstrating, Tutoring (231) / Research Work – Clinically Qualified (221)
Academic Clinically-Qualified Teaching, Examining, Demonstrating, inc. Dental (221) / Research Work – Engineering areas (212)
Veterinary Professional Work e.g. surgery, anaesthesia (221) / Research Work – IT & Computer Science areas (213)
Nurse Tutor work (223) / Research Work – all other areas (211)
Other Academic Activity– please specify type of work / Non-academic activity- Please tick if work is a non-academic activity
Line Manager Signature
Print Name / Position
Department Authorised Signature
Print Name / Position
Departmental Checklist (to be completed before submission to Payroll)
Copy of Passport (Including Cover + verified by department) attached / YES / NO
Copy of Current Visa (If not UK / EU Passport Holder) attached / YES / NO
P46 / P45 attached (link to P46 / YES / NO
Check madethat authorised signatory is on the central Finance authorised signatory list / YES / NO
Worker informed timesheets must be completed to claim for work undertaken / YES / NO
Timesheets provided to new starter to complete / YES / NO
Casual worker provided with a copy of this form as a record of the agreed work to be undertaken and the agreed rate of pay / payment applicable to the work. / YES / NO
If one-off payment is being paid please state the name of the HR Manager that has approved this.
Name of departmental contact who has checked and e-mailed form to Payroll (Please print name) / Date
Email Address / Tel Ex

CasNS/Ver2.1/Oct’12/MC